Domestic Violence Against HIV-Positive Women and Its Impact on Their Health

Several terms are used by researchers who study violence against women committed by men who are their partners. Examples of such terms include the following:

domestic violence

gender-based violence

intimate partner violence (IPV)

The United States Institute of Medicine (IOM) now recommends that healthcare professionals screen and counsel all women for IPV.

Past research in sub-Saharan Africa, India and the U.S. has found that IPV is a risk factor for women acquiring HIV. However, little research has been done to explore the impact of IPV on the health of HIV-positive women.

Now researchers in Calgary, Alberta, have conducted a study to assess the presence of IPV among HIV-positive women as well as its impact on their health. Their findings are distressing -- IPV is common, reported by 40% of HIV-positive women in the region's major clinic. Furthermore, HIV-positive women who disclosed IPV had worse health and quality of life compared to other HIV-positive women who did not report IPV. Indeed, HIV-positive women who reported IPV were more likely to have been hospitalized even after initiating care for HIV.

The present study has uncovered a high rate of IPV among HIV-positive women and documented a link to increased hospitalization in affected women. Hospital stays arising from any cause, including IPV, are costly for the healthcare system. These factors should encourage policy planners and regional health departments to intensify programs to help prevent IPV and treat women, particularly those with HIV, affected by abuse. By building a trusting relationship with HIV-positive women, healthcare providers can help engage these women into care and improve the women's overall health and well-being.

Study Details

The Alberta research team noted that there are several types of abuse that can be directed at people, including the following:

physical abuse

sexual abuse

emotional abuse

financial abuse

isolation

neglect

intimidation

As part of their study, the research team screened HIV-positive women for these types of abuse during the course of routine clinic visits between May 2009 and Jan 2012. Any woman who disclosed abuse was offered further care with a social worker who had expertise dealing with IPV among HIV-positive people.

Results

Nearly 80% (339 women) of women receiving HIV care in Southern Alberta were screened for abuse during the study. The main findings were as follows:

40% (137) of women reported a history of IPV

among the 137 women who disclosed a history of abuse, 20% reported that abuse occurred in their current relationship

8% (11) of women who experienced abuse disclosed that abuse occurred both in their past and current relationships

22% of the 137 women who reported a history of IPV also disclosed a history of childhood abuse

Common forms of abuse included the following:

emotional

physical

sexual

However, the researchers stated that most women (72%) disclosed that they "experienced multiple types of abuse."

Race and Ethnicity

The research team found that Aboriginal and white women reported high rates of IPV as follows:

Aboriginal women -- 65%

white women -- 61%

In contrast, black women, most of whom were immigrants from sub-Saharan Africa, reported a lower rate of IPV (22%).

IPV, Substance Use and Imprisonment

The researchers found that women who had a history of IPV were significantly more likely to do the following:

use street drugs

use tobacco or have a history of smoking

The research team found that IPV did not predict the "excessive" use of alcohol.

The study was mostly cross-sectional in nature; this is akin to taking a snapshot of a group of people at one time and studying the data captured, rather than conducting a longer and more expensive study that monitors participants for many years. As a result of the nature of the study, the timing of substance use in relation to abuse is not clear. However, it is likely that substance use occurred after IPV as women sought temporary refuge from the psychological burden imposed by abuse.

The researchers found it noteworthy that 19 out of 25 women who had a history of being imprisoned reported IPV.

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